| NPI | 1639561749 |
|---|---|
| Former Name | AMBER MARIE BASS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: NJ 26NJ00724100) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: PA SP015969) |
| Enumeration Date | 2015-02-26 |
| Last Update Date | 2021-02-11 |